638 POISONS : THEIR EFFECTS AND DETECTION. [§ 813 . 
and throat ; vomiting, which occurs usually within fifteen minutes, is 
in very rare cases delayed from one to two hours. The retching and 
vomiting are very obstinate, and continue for a long time ; the matters 
thrown up are sometimes streaked with blood ; there is pain in the 
abdomen of a colicky character—a pain relieved by pressure. The 
bowels are, as a rule, constipated, but occasionally relaxed. The stools 
at a later date are black from the presence of lead sulphide. The 
urine, as a rule, is diminished. The breath has a foul odour, and the 
tongue is coated ; the skin is dry, and the pulse small and frequent. 
The full development of the toxic action is completed by the appearance 
of various nervous phenomena—headache, shooting pains in the limbs, 
cramps in the legs, and local numbness. All the symptoms enumerated 
are not present in each case ; the most constant are the vomiting and 
the colic. If the sufferer is to die, death occurs about the second or 
third day. If the patient recovers, convalescence may be much 
retarded, as shown in the case of two girls, 1 who had each swallowed 
an ounce of lead acetate by mistake, and who suffered even after the 
lapse of a year from pain and tenderness in the stomach, and sickness. 
There are “ mass-poisonings ” by acetate of lead on record, which 
afford considerable insight into the varying action of this salt on 
different individuals. A case (e.g.) occurred at Stourbridge in 1840, 2 
in which no less than 500 people were poisoned by thirty pounds of 
lead acetate being accidentally mixed with eighty sacks of flour at a 
miller’s. The symptoms commenced after a few days—constriction of 
the throat, cramping and twisting pains round the umbilicus, rigidity 
of the abdominal muscles, dragging pains at the loins, cramps and 
paralysis of the lower extremities. There was obstinate constipation ; 
the urine was scanty and of a deep red colour, and the secretions were 
generally arrested ; the pulse was slow and feeble ; the countenance 
depressed, often livid ; and the gums showed the usual blue line. The 
temperature of the skin was low. In only a few cases was there sick¬ 
ness, and in these it soon ceased. It is curious that not one of the 
500 cases proved fatal, although some of the victims were extremely 
ill, and their condition alarming. It was specially observed that, after 
apparent convalescence, the symptoms, without any obvious cause, 
suddenly returned, and this even in a more aggravated form. Remit¬ 
tance of this kind is of medico-legal import ; it might, for example, be 
wrongly inferred that a fresh dose had been taken. In the 500 cases 
there were no inflammatory symptoms ; complete recovery took some 
time. On examining the bread the poison was found so unequally 
distributed that no idea could be formed as to the actual amount 
taken. 
1 Prov. Med. Journal, 1846. 
2 Recorded by Mr Bancks, Lancet, May 5 , 1849, p. 478. 
